On July 1, 2012, New York State enacted the Concussion Management and Awareness Act. The Commissioner of Education worked with the Commissioner of Health to produce guidelines for school districts to follow in protecting the health and well-being of concussed students. The Fonda-Fultonville Central School District has responded to the New York State Concussion Management and Awareness Act by developing a district-wide Concussion Management Protocol. This Protocol outlines procedures for district staff, parents, and students to follow in managing head injuries; as well as guidance in returning to activities following a concussion.
What is a concussion?
A concussion is a reaction by the brain to a jolt or force that can transmitted to the head by an impact or blow occurring anywhere on the body. Essentially, a concussion results from the brain moving back and forth or twisting rapidly inside the skull.
Facts about concussions from the Center for Disease Control (CDC)
- An estimated 4 million people under age 19 sustain a head injury annually. Of these, approximately 52,000 die and 275,000 are hospitalized.
- An estimated 300,000 sports and recreation related concussions occur every year.
- Students who have had at least one concussion are at an increased risk for another concussion.
In New York State in 2009, approximately 50,500 children under the age of 19 visited the emergency room for a traumatic brain injury, and of those, approximately 3,000 were hospitalized.
Requirements of School Districts
Education:
- Each school coach, physical education teacher, nurse, and athletic trainer will have to complete an approved course on concussion management on biennial basis, starting with the 2012-2013 school year.
- School coaches and physical education teachers must complete the CDC course.
- School nurses and certified athletic trainers must complete the concussion course.
Information:
- Districts must provide parents concussion management information and have parents sign a parental permission form.
Removal from Athletics:
- Any student that has or is believe to have sustained a mild traumatic injury must immediately be removed from athletic activities.
- No students will be allowed to resume athletic activity until they have been symptom free for 25 hours and have been evaluated by and received written and signed authorization from a licensed physician. For interscholastic athletics, clearance must come from the school medical director.
- Such authorization must be kept in the student’s permanent health record.
- Schools shall follow directives issued by the student’s treating physician.
Symptoms
Symptoms of a concussion are the result of a temporary change in the brain’s function. In most cases, the symptoms of a concussion generally resolve over a short period of time; however, in some cases, symptoms will last for weeks or longer. Children and adolescents are more susceptible to concussions and take longer than adults to recover.
It is imperative that any student who is suspected of having a concussion is removed from athletic activity (e.g. recess, PE class, sports) and remains out of such activities until evaluated and cleared to return to activity by a physician.
Symptoms include, but are not limited to:
- Decreased or absent memory of events prior to or immediately after the injury, or difficulty retaining new information
- Confusion or appears dazed
- Headache or head pressure
- Loss of consciousness
- Balance difficulties, dizziness, or clumsy movements
- Double or blurry vision
- Sensitivity to light and/or sound
- Nausea, vomiting and/or loss of appetite
- Irritability, sadness, or other changes in personality
- Feeling sluggish, foggy, or light-headed
- Concentration or focusing problems
- Drowsiness
- Fatigue and/or sleep issues, or sleeping more than usual
Students who develop any of the following signs, or if signs and symptoms worsen, should be seen and evaluated immediately at the nearest hospital emergency room.
- Headaches that worsen
- Seizures
- Looks drowsy and/or cannot be awakened
- Repeated vomiting
- Slurred speech
- Unable to recognize people or places
- Weakness or numbing in arms or legs, facial drooping
- Unsteady gait
- Change in pupil size in one eye
- Significant irritability
- Any loss of consciousness
- Suspicion for skull fracture: blood draining from ear or clear fluid from the nose
Return to Learn or Return to Play Protocols
Cognitive Rest: Activities students should avoid include, but are not limited to, the following:
- Computers and video games
- Television viewing
- Texting
- Reading or writing
- Studying or homework
- Taking a test or completing significant projects
- Loud music
- Bright lights
Students may only be able to attend school for short periods of time. Accommodations may have to be made for missed tests and assignments.
Physical Rest: Activities students should avoid include, but are not limited to, the following:
- Contact and collision
- High speed, intense exercise and/or sports
- High risk for re-injury or impacts
- Any activity that results in an increased heart rate or increased head pressure
Return to Play Protocol
One symptom free for 24 hours and cleared by medical staff:
- Day 1: Low impact, non-strenuous, light aerobic activity.
- Day 2: Higher impact, higher exertion, moderate aerobic activity, no resistance training.
- Day 3: Sport specific non-contact activity. Low resistance weight training with a spotter.
- Day 4: Sport specific activity, non-contact drills. Higher resistance weight training with a spotter.
- Day 5: Full contact training drills and intense aerobic activity.
- Day 6: Return to full activities with clearance from medical staff.
Any return of symptoms during the return to play protocol, the student will return to previous day’s activities until they are symptom free.